Vnitřní lékařství, 1994 (vol. 40), issue 5
[Metabolic and humoral variations during the development of essential hypertension].
K Horký, M Jáchymová, A Jindra, J Savlíková, J Peleska, V Umnerová, M Jarolím
Vnitr Lek 1994, 40(5):271-277
Some metabolic and humoral deviations found in normotensive offspring from hypertensive families can be modified in the course of years either as a result of ageing or of the clinical manifestation of essential hypertension (EH). The authors compared therefore some metabolic indicators (blood sugar level, IRI, C-peptide and plasma lipids) and humoral factors (plasma catecholamines, renin activity, atrial natriuretic factor and endothelin) in four groups of subjects: 27 young normotensive sons from normotensive families (SNF) and 30 from hypertensive families (SHF) with the findings of normotonics (NT) (n = 21) and patients with EH (n = 21) by 15 years...
[Changes in humoral pressor and depressor factors in essential hypertension during lisinopril therapy].
J Peleska, K Horký, M Jáchymová, M Jarolím, A Jindra, J Kolár, J Savlíková, P Stolba, V Umnerová, Z Vorlová
Vnitr Lek 1994, 40(5):278-283
Arterial hypertension is nowadays no longer considered an isolated disorder of blood pressure regulation but a multifactorial disease with metabolic and cellular deviations. From the therapeutic aspect of thus conceived hypertension today inhibitors of the angiotensin converting enzyme seem most promising. With regard to their assumed comprehensive effect, the authors investigated simultaneously selected pressor and depressor humoral indicators and other indicators in 21 hypertensive patients with stage I and II of essential hypertension before and after three-month treatment with an angiotensin converting enzyme inhibitor lisinopril (Prinivil, Merck,...
[Revascularization procedures on coronary vessels. Development of techniques, indications and results].
J Fabián, M Pavlovic, V Fischer, I Riecanský
Vnitr Lek 1994, 40(5):284-292
Hitherto assembled experience indicates that the principles and immediate results of surgical and reconstructive intervention surgery of coronary arteries are very close and similar. Criteria of indication and technical possibilities in both these areas are developing and improving steadily. Accurate definition of the optimal use of these techniques does not exist so far. At present several perspective investigations are under way and they could provide within the next few months an answer and define the areas of these two basic reconstruction operations of the coronary arteries. Regardless of that the two methods are nowadays already a routine procedure...
[Actilyse (a recombinant tissue-type plasminogen activator] in the treatment of acute myocardial infarct. Comparison of the effects of Actilyse and streptokinase].
J Bastecký, J Kvasnicka, K Macek, J Malý, V Rozsíval, L Chrobák, I Gajdosová, H Skopecková, V Wasylivová, E Ettlerová
Vnitr Lek 1994, 40(5):293-298
The preparation Actilyse--a tissue plasminogen activator prepared by recombination--is an effective fibrinolytic drug. The authors recorded in a group of 33 patients reperfusion in 91%, evaluated on the basis of indirect criteria. In a group of 18 patients treated with streptokinase reperfusion was achieved in 74%. Based on changes of CK and CK-MB values--an earlier rise of values following Actilyse administration and conversely their more marked increase during subsequent sampling after streptokinase administration--it may be assumed that earlier dissolution of the thrombus in the coronary artery occurs after Actilyse administration, as compared with...
[Renal excretion of calcium in healthy persons].
M Ochodnický, E Ochodnická, E Martinka, M Mokán, D Holanová
Vnitr Lek 1994, 40(5):299-302
The authors examined the calcium excretion in a group of 100 healthy subjects (50 men and 50 women) aged 21-40 years. Urine was collected under ambulatory conditions. Calcium excretion was expressed as Ca excretion per minute, Nordin's index, calciuria/GF.1.73 m2 and the renal threshold for calcium. Calcium excretion per minute was significantly lower in women, as compared with men. This significant difference of mean values of calcium excretion per minute persists when the subjects are classified by sex and age groups. Women aged 31-40 years had a significantly lower calciuria/GF.1.73 m2 than men aged 21-30 years and a significantly higher renal threshold...
[Measurement of flow in an arteriovenous fistula and its prognostic significance].
P Stverák, D Balabán
Vnitr Lek 1994, 40(5):303-305
The authors describe a non-invasive, not time consuming and relatively accurate assessment of the flow through an arteriovenous fistula and draw attention to the prognostic importance of blood flow values for preservation of the arteriovenous communication in patients participating in a long-term dialyzation programme.
[The effect of intensive insulin therapy on specific long-term complications in type II diabetes].
B Podrouzková
Vnitr Lek 1994, 40(5):306-309
Hundred and ten type 2 diabetics with complications, mean age 58.1 years, were treated intensively with insulin for a 12-month period using CSII in an attempt to stabilize the development of specific complications. During 12 months of treatment their long-term compensation corresponded to a value of 7.8 HbA1c. It proved possible to influence in a favourable way complications in 48 patients, i.e. in 43.6%. The greatest improvement was recorded in peripheral sensory neuropathy, less frequently sensorimotor neuropathy. In patients with nephropathy in 33% quantitative proteinuria dropped below 500 mg/24 hr. Retinopathies were not affected, on the contrary,...
[The importance of concurrent therapy with insulin and sulfonylurea derivatives in type II diabetes].
B Podrouzková
Vnitr Lek 1994, 40(5):310-312
The author presents an account of combined treatment with insulin and sulphonylurea derivatives in 46 diabetics type 2 for a period of three years. In all patients satisfactory metabolic compensation was achieved which persisted throughout the whole period at a level of HbA1c values of 8.0-8.5%. The author considers combined treatment indicated in secondary failure of oral antidiabetics with preserved C peptide secretion of 0.8-0.24 ng/ml. Combined treatment may be also a solution for some metabolically unbalanced diabetes type 2 with obesity and hyperinsulinaemia. Combined treatment is useful, does not burden the patient with large insulin doses and...
[Evidence of the value of good compensation in diabetes (conclusions of the Diabetes Control and Complications Trial)].
J Rybka
Vnitr Lek 1994, 40(5):313-315
The Diabetes Control and Complications Trial--DCCT--is the longest and largest perspective study in the history of diabetes which provides evidence that reduction of the blood sugar level delays or prevents the development of late diabetic complications. The main conclusions of DCCT proved that correct metabolic control reduces the risk of late diabetes, and to the majority of patients with IDDM intensified treatment should be recommended. DCCT confirmed also the correctness of therapeutic recommendations given in the Saint Vincent declaration.
[Hypoglycemia and modern treatment of diabetes].
J Páv
Vnitr Lek 1994, 40(5):316-319
During insulin treatment, when the objective is to achieve blood sugar levels as close as possible to normal values by an intensified regime, hypoglycaemia is three times as frequent as compared with the conventional regime. The author discusses in the submitted review the relationship between a reduced blood sugar level and associated symptoms, he describes the counterregulation reparative response and draws attention to its changes in conjunction with prolonged duration of diabetes and mentions short-term as well as long-term consequences of hypoglycaemia. In the conclusion he mentions possible ways how to prevent this complication of insulin treatment.
[Recent findings on type II non-insulin-dependent diabetes (epidemiologic data, etiopathogenesis)].
J Rybka
Vnitr Lek 1994, 40(5):320-324
Although NIDDM is by far the most frequent form of diabetes, the pathogenesis is less clear and even more controversial than in IDDM. There is a heterogeneity of IDDM and NIDDM and there are reasons why the two types should be considered different diseases although we do not know exactly why. NIDDM is the result of a disbalance between insulin sensitivity and insulin secretion. Fully developed NIDDM syndrome calls for the concurrent existence of both main defects, i.e. insulin resistance and deteriorated B-cell function. It is important that the two defects must occur simultaneously, only then marked glucose intolerance develops. Concurrent hyperglycaemia...
[Geriatric maladaptation syndrome].
L Hegyi, S Cagán
Vnitr Lek 1994, 40(5):325-328
Geriatric maladaptation syndrome is a demonstration of adaptation failure, which is typical for higher age. This failure occurred on the basis of chronic stress caused usually by relevant psychosocial stimulus, with clinical manifestation mainly in cardiovascular or immune systems followed with serious threaten of health and life. A lost of independence, loneliness, change of dwelling-place and living standard, low income, stages of confusion, mental disease, passive life attitude belong to psychosocial risks of the origin of geriatric maladaptation syndrome. Higher age and bad health status belong to biological risks of the origin of geriatric maladaptation...
[Therapeutic use of interferon beta].
Z Adam, J Vorlícek
Vnitr Lek 1994, 40(5):329-333
All types of interferon (alpha, beta, gamma) have a virostatic immunomodulating and antiproliferative effect. There are, however, quantitative differences between different interferons as regards the mentioned properties. Interferon beta has a marked antiviral action, and therefore it is used in a dose of 0.5 x 10(6) IU/kg in long-term infusions in life-endangering viral infections. Interferon beta differs from interferon alpha by a higher lipophilia and thus greater tissue affinity. It is therefore useful for local treatment. Local administration is used in severe infections of the anterior segment of the eye and in relapses of condyloma accuminatum...